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Almaliotis D, Almpanidou S, Chatzimbalis T, Nikolaidou A, Talimtzi P, Karampatakis V. Correlation between color vision, visual acuity, contrast sensitivity and photostress recovery in the visually impaired: a cross-sectional study. Ann Med Surg (Lond) 2024; 86:742-747. [PMID: 38333302 PMCID: PMC10849460 DOI: 10.1097/ms9.0000000000001522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 11/09/2023] [Indexed: 02/10/2024] Open
Abstract
Background To investigate the correlation of colour vision, visual acuity, contrast sensitivity, and photostress recovery time test scores in visually impaired patients. Materials and methods A total of 133 subjects were enroled and 133 eyes were examined. The pathological group consisted of 76 (57.1%) males with an average age of 68.0 (SD=13.2) and 57 (42.9%) females, with an average age of 68.1 (SD=15.2), Mann-Whitney U test was used to evaluate the differences in K-colour tests, HRR, visual acuity, Contrast Sensitivity test and photostress recovery time test between two different groups of severity. Results Correlations were found among colour vision tests, visual acuity, contrast sensitivity, and photostress recovery time scores in eyes with age-related macular degeneration, with diabetic retinopathy, with optic nerve diseases, and various other retinal diseases (P<0.05). In patients with moderate-visual impairments. Conclusions The colour vision test scores correlate with the scores of visual acuity, contrast sensitivity, and photostess recovery time test. It may be a useful clinical surrogate for functional vision.
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Affiliation(s)
- Diamantis Almaliotis
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Greece
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2
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Hazirolan D, Duman M, Guler SK, Uney G, Ornek F. Retinal ganglion cell complex and visual evoked potentials in levetiracetam treatment. Cutan Ocul Toxicol 2020; 39:237-243. [PMID: 32543904 DOI: 10.1080/15569527.2020.1778016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE To examine central macular, RNFL (retinal nerve fibre layer), GCC (ganglion cell complex) thicknesses; and VEPs (visual evoked potential) in epileptic patients using levetiracetam for at least one year. MATERIALS AND METHODS Sixteen focal epileptic patients receiving levetiracetam monotherapy and 16 healthy subjects were included in the study. Central macular, RNFL and GCC thicknesses according to spectral domain OCT (optical coherence tomography); and VEPs parameters were compared between patients and healthy subjects. RESULTS The mean age of patient and control groups were 40 ± 16 and 38 ± 12 years respectively (p > 0.05). The patient group was on levetiracetam therapy for 64 ± 45 (12-168) months. Central macular thickness was thinner in the patient group (p = 0.008). There was no difference among groups regarding RNFL thicknesses. GCC thicknesses in all quadrants were similar among groups, except the superior quadrant; which was thinner in the patient group (p = 0.03). P100 amplitude in 30 min pattern was lower in the patient group (p = 0.04). N135 latency in 15 min (p = 0.03) and 7 min patterns (p = 0.01) was longer in the patient group. CONCLUSION Central macular and GCC thicknesses; and VEP parameters in patients receiving levetiracetam treatment may differ from healthy subjects.
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Affiliation(s)
- Dicle Hazirolan
- Ankara Training and Research Hospital, Ophthalmology Department, University of Health Sciences, Ankara, Turkey
| | - Melih Duman
- Ankara City Hospital, Ophthalmology Department, University of Health Sciences, Ankara, Turkey
| | - Selda Keskin Guler
- Ankara Training and Research Hospital, Neurology Department, University of Health Sciences, Ankara, Turkey
| | - Guner Uney
- Ankara Training and Research Hospital, Ophthalmology Department, University of Health Sciences, Ankara, Turkey
| | - Firdevs Ornek
- Ankara Training and Research Hospital, Ophthalmology Department, University of Health Sciences, Ankara, Turkey
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3
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Bayraktar Bilen N, Titiz AP, Bilen S, Polat Gultekin B, Sahin Hamurcu M, Kalayci D. Optical coherence tomography and neurodegeneration in epilepsy. Eur J Ophthalmol 2019; 31:252-257. [PMID: 31645118 DOI: 10.1177/1120672119881982] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To compare optical coherence tomography measurements; central macular thickness, ganglion cell complex, and retinal nerve fiber layer thickness in patients with epilepsy versus healthy controls. METHODS We evaluated 28 eyes of 28 patients with epilepsy and 34 eyes of 34 healthy subjects. Central macular thickness, ganglion cell complex, and retinal nerve fiber layer thickness measurements were performed by spectral-domain optical coherence tomography. RESULTS Superior and superotemporal quadrant ganglion cell complex, average, and superior quadrant retinal nerve fiber layer thickness measurements were significantly lower in epilepsy group compared to healthy control subjects. Central macular thickness was significantly lower in polytherapy group compared to monotherapy group. Ganglion cell complex and retinal nerve fiber layer thickness measurements were not significantly different between polytherapy and monotherapy groups. CONCLUSION The present study shows that epileptic patients taking antiepileptic drugs have reduced ganglion cell complex and retinal nerve fiber layer thickness compared to healthy controls. This can be related to the epileptic process in the brain. Optical coherence tomography may be a useful tool for showing the neurodegeneration in patients with epilepsy.
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Affiliation(s)
- Neslihan Bayraktar Bilen
- Department of Ophthalmology, Ankara Numune Training and Research Hospital, Ankara, Turkey.,Department of Neurology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Ayse Pinar Titiz
- Department of Ophthalmology, Ankara Numune Training and Research Hospital, Ankara, Turkey.,Department of Neurology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Sule Bilen
- Department of Ophthalmology, Ankara Numune Training and Research Hospital, Ankara, Turkey.,Department of Neurology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Burcu Polat Gultekin
- Department of Ophthalmology, Ankara Numune Training and Research Hospital, Ankara, Turkey.,Department of Neurology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Mualla Sahin Hamurcu
- Department of Ophthalmology, Ankara Numune Training and Research Hospital, Ankara, Turkey.,Department of Neurology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Defne Kalayci
- Department of Ophthalmology, Ankara Numune Training and Research Hospital, Ankara, Turkey.,Department of Neurology, Ankara Numune Training and Research Hospital, Ankara, Turkey
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Hamed SA. Ocular dysfunctions and toxicities induced by antiepileptic medications: Types, pathogenic mechanisms, and treatment strategies. Expert Rev Clin Pharmacol 2019; 12:309-328. [PMID: 30840840 DOI: 10.1080/17512433.2019.1591274] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Ocular dysfunctions and toxicities induced by antiepileptic drugs (AEDs) are rarely reviewed and not frequently received attention by treating physicians compared to other adverse effects (e.g. endocrinologic, cognitive and metabolic). However, some are frequent and progressive even in therapeutic concentrations or result in permanent blindness. Although some adverse effects are non-specific, others are related to the specific pharmacodynamics of the drug. Areas covered: This review was written after detailed search in PubMed, EMBASE, ISI web, SciELO, Scopus, and Cochrane Central Register databases (from 1970 to 2019). It summarized the reported ophthalmologic adverse effects of the currently available AEDs; their risks and possible pathogenic mechanisms. They include ocular motility dysfunctions, retinopathy, maculopathy, glaucoma, myopia, optic neuropathy, and impaired retinal vascular autoregulation. In general, ophthalmo-neuro- or retino-toxic adverse effects of AEDs are classified as type A (dose-dependent), type B (host-dependent or idiosyncratic) or type C which is due to the cumulative effect from long-term use. Expert opinion: Ocular adverse effects of AEDs are rarely reviewed although some are frequent or may result in permanent blindness. Increasing knowledge of their incidence and improving understanding of their risks and pathogenic mechanisms are crucial for monitoring, prevention, and management of patients' at risk.
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Affiliation(s)
- Sherifa A Hamed
- a Department of Neurology and Psychiatry , Assiut University Hospital , Assiut , Egypt
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5
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Annadanam A, Zhao J, Wang J, Eghrari AO. Effects of Contrast Sensitivity on Colour Vision Testing. Neuroophthalmology 2017; 41:182-186. [PMID: 29344056 DOI: 10.1080/01658107.2017.1295273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 02/11/2017] [Indexed: 10/19/2022] Open
Abstract
This study analyses how contrast sensitivity loss affects colour vision (CV) testing. Eleven participants were scored while cycling through randomly arranged pictures of CV tests with varying levels of contrast changes applied. Hardy-Rand-Rittler (HRR) scores declined significantly at each successive decrease in contrast level after the highest setting (p < 0.004). HRR scores were also lower than those for Ishihara and Farnsworth D-15 tests at two contrast settings (p < 0.01). Contrast changes had the greatest impact on HRR scores, indicating that this test may not be an accurate reflection of CV in patients with contrast sensitivity loss.
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Affiliation(s)
- Anvesh Annadanam
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jiawei Zhao
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jiangxia Wang
- Johns Hopkins University School of Medicine, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Allen O Eghrari
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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6
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Zhao J, Davé SB, Wang J, Subramanian PS. Clinical color vision testing and correlation with visual function. Am J Ophthalmol 2015; 160:547-552.e1. [PMID: 26116263 DOI: 10.1016/j.ajo.2015.06.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Revised: 06/14/2015] [Accepted: 06/16/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE To determine if Hardy-Rand-Rittler (H-R-R) and Ishihara testing are accurate estimates of color vision in subjects with acquired visual dysfunction. DESIGN Assessment of diagnostic tools. METHODS Twenty-two subjects with optic neuropathy (aged 18-65) and 18 control subjects were recruited prospectively from an outpatient clinic. Individuals with visual acuity (VA) <20/200 or with congenital color blindness were excluded. All subjects underwent a comprehensive eye examination including VA, color vision, and contrast sensitivity testing. Color vision was assessed using H-R-R and Ishihara plates and Farnsworth D-15 (D-15) discs. D-15 is the accepted standard for detecting and classifying color vision deficits. Contrast sensitivity was measured using Pelli-Robson contrast sensitivity charts. RESULTS No relationship was found between H-R-R and D-15 scores (P = .477). H-R-R score and contrast sensitivity were positively correlated (P = .003). On multivariate analysis, contrast sensitivity (β = 8.61, P < .001) and VA (β = 2.01, P = .022) both showed association with H-R-R scores. Similar to H-R-R, Ishihara score did not correlate with D-15 score (P = .973), but on multivariate analysis was related to contrast sensitivity (β = 8.69, P < .001). H-R-R and Ishihara scores had an equivalent relationship with contrast sensitivity (P = .069). CONCLUSION Neither H-R-R nor Ishihara testing appears to assess color identification in patients with optic neuropathy. Both H-R-R and Ishihara testing are correlated with contrast sensitivity, and these tests may be useful clinical surrogates for contrast sensitivity testing.
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Affiliation(s)
- Jiawei Zhao
- Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Sarita B Davé
- Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jiangxia Wang
- Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Prem S Subramanian
- Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
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Tunali S, Kahraman S, Yanardag R. Vitamin U, a novel free radical scavenger, prevents lens injury in rats administered with valproic acid. Hum Exp Toxicol 2014; 34:904-10. [DOI: 10.1177/0960327114561665] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Valproic acid (2-propyl-pentanoic acid, VPA) is the most widely prescribed antiepileptic drug due to its ability to treat a broad spectrum of seizure types. VPA exhibits various side effects such as organ toxicity, teratogenicity, and visual disturbances. S-Methylmethioninesulfonium is a derivative of the amino acid methionine and it is widely referred to as vitamin U (Vit U). This study was aimed to investigate the effects of Vit U on lens damage parameters of rats exposed to VPA. Female Sprague Dawley rats were divided into four groups. Group I comprised control animals. Group II included control rats supplemented with Vit U (50 mg/kg/day) for 15 days. Group III was given only VPA (500 mg/kg/day) for 15 days. Group IV was given VPA + Vit U (in same dose and time). Vit U was given to rats by gavage and VPA was given intraperitoneally. On the 16th day of experiment, all the animals which were fasted overnight were killed. Lens was taken from animals, homogenized in 0.9% saline to make up to 10% (w/v) homogenate. The homogenates were used for protein, glutathione, lipid peroxidation levels, and antioxidant enzymes activities. Lens lipid peroxidation levels and aldose reductase and sorbitol dehydrogenase activities were increased in VPA group. On the other hand, glutathione levels, superoxide dismutase, glutathione peroxidase, glutathione reductase, glutathione- S-transferase, and paraoxonase activities were decreased in VPA groups. Treatment with Vit U reversed these effects. This study showed that Vit U exerted antioxidant properties and may prevent lens damage caused by VPA.
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Affiliation(s)
- S Tunali
- Department of Chemistry, Faculty of Engineering, Istanbul University, Avcilar, Istanbul, Turkey
| | - S Kahraman
- Department of Food Engineering, Faculty of Engineering, Istanbul Aydin University, Kucukcekmece, Istanbul, Turkey
| | - R Yanardag
- Department of Chemistry, Faculty of Engineering, Istanbul University, Avcilar, Istanbul, Turkey
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A new computer-based Farnsworth Munsell 100-hue test for evaluation of color vision. Int Ophthalmol 2013; 34:747-51. [PMID: 24097078 DOI: 10.1007/s10792-013-9865-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Accepted: 09/23/2013] [Indexed: 10/26/2022]
Abstract
To evaluate a computer-based Farnsworth-Munsell (FM) 100-hue test and compare it with a manual FM 100-hue test in normal and congenital color-deficient individuals. Fifty color defective subjects and 200 normal subjects with a best-corrected visual acuity ≥ 6/12 were compared using a standard manual FM 100-hue test and a computer-based FM 100-hue test under standard operating conditions as recommended by the manufacturer after initial trial testing. Parameters evaluated were total error scores (TES), type of defect and testing time. Pearson's correlation coefficient was used to determine the relationship between the test scores. Cohen's kappa was used to assess agreement of color defect classification between the two tests. A receiver operating characteristic curve was used to determine the optimal cut-off score for the computer-based FM 100-hue test. The mean time was 16 ± 1.5 (range 6-20) min for the manual FM 100-hue test and 7.4 ± 1.4 (range 5-13) min for the computer-based FM 100-hue test, thus reducing testing time to <50 % (p < 0.05). For grading color discrimination, Pearson's correlation coefficient for TES between the two tests was 0.91 (p < 0.001). For color defect classification, Cohen's agreement coefficient was 0.98 (p < 0.01). The computer-based FM 100-hue is an effective and rapid method for detecting, classifying and grading color vision anomalies.
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9
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Abstract
A variety of newer antiepileptic drugs (AEDs) are now available for treating patients with epilepsy in addition to the 'conventional' drugs that have been available throughout a large part of the last century. Since these drugs act to suppress the pathological neuronal hyperexcitability that constitutes the final substrate in many seizure disorders, it is not surprising that they are prone to causing adverse reactions that affect the CNS.Information on adverse effects of the older AEDs has been mainly observational. Equally, whilst the newer drugs have been more systematically studied, their long-term adverse effects are not clearly known. This is illustrated by the relatively late emergence of the knowledge of visual field constriction in the case of vigabatrin, which only became known after several hundred thousand patient-years of use. However, older drugs continue to be studied and there has been more recent comment on the possible effect of valproate (valproic acid) on cognition following exposure to this drug in utero.With most AEDs, there are mainly dose-related adverse effects that could be considered generic, such as sedation, drowsiness, incoordination, nausea and fatigue. Careful dose titration with small initial doses can reduce the likelihood of these adverse effects occurring. Adverse effects such as paraesthesiae are more commonly reported with drugs such as topiramate and zonisamide that have carbonic anhydrase activity. Weight loss and anorexia can also be peculiar to these drugs. Neuropsychiatric adverse effects are reported with a variety of AEDs and may not be dose related. Some drugs, such as carbamazepine when used to treat primary generalized epilepsy, can exacerbate certain seizure types. Rare adverse effects such as hyperammonaemia with valproate are drug specific. There are relatively very few head-to-head comparisons of AEDs and limited information is available in this regard.In this review, we discuss the available literature and provide a comprehensive summary of adverse drug reactions of AEDs affecting the CNS.
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Affiliation(s)
- Gina M Kennedy
- Department of Neurology, Institute of Clinical Neurosciences, Frenchay Hospital, Bristol, England
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10
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Verrotti A, Manco R, Matricardi S, Franzoni E, Chiarelli F. Antiepileptic drugs and visual function. Pediatr Neurol 2007; 36:353-60. [PMID: 17560495 DOI: 10.1016/j.pediatrneurol.2007.03.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2006] [Revised: 12/20/2006] [Accepted: 03/22/2007] [Indexed: 01/23/2023]
Abstract
Antiepileptic drugs are known to result in visual disturbances. A number of antiepileptic drugs have recently been reported to result in various abnormalities of vision, particularly deficiencies in visual fields and color vision. Moreover, there has been a marked improvement in the diagnosis and understanding of the pathophysiology of visual disturbance. This review collects evidence for visual adverse effects induced by the older antiepileptic drugs (barbiturates, benzodiazepine, carbamazepine, valproic acid, ethosuximide, and phenytoin) and the newer ones (vigabatrin, topiramate, tiagabine, levetiracetam, lamotrigine, gabapentin, felbamate, and oxcarbazepine).
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11
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Verrotti A, Lobefalo L, Tocco AM, Spalice A, Gallenga PE, Chiarelli F, Iannetti P. Color vision and macular recovery time in epileptic adolescents treated with valproate and carbamazepine. Eur J Neurol 2006; 13:736-41. [PMID: 16834703 DOI: 10.1111/j.1468-1331.2006.01213.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Visual dysfunction has been reported in patients diagnosed with epilepsy. Some of these visual disturbances may be attributable to either the disease process, or the anticonvulsant therapy prescribed to control the seizures. The aims of our study were to evaluate whether color vision and macular function are impaired in epileptic adolescents, to study if the monotherapy with valproic acid (VPA) and carbamazepine (CBZ) can affect color vision and macular function and to determine the possible relationship between color vision, retinal function and antiepileptic drugs (AEDs) dosage and their serum concentrations. We examined 45 (16 male and 29 female, mean age +/- SD, 15.71 +/- 2.01 years) Caucasian epileptic patients suffering from various types of cryptogenic epilepsy before the beginning of therapy and after 1 year of VPA or CBZ monotherapy and 40 sex- and age-matched healthy controls. Color vision was assessed by Farnsworth Munsell (FM) 100-hue test and total error score (TES) was evaluated. This test consists of colored caps: the testee has to arrange the caps according to their colors macular function was assessed by nyctometry evaluating initial recovery time (IRT) and summation method (SM). This test evaluates visual acuity after a period of intense illumination of macula. Analysis of variance was used to evaluate the difference between controls and patients; moreover, Pearson's correlation test have been performed. Before the beginning of therapy, there were no differences in color vision and macular function between controls and epileptic patients. After 1 year, the patients, treated with VPA or CBZ, showed a deficit in FM 100-hue test. At nyctometry, all patients showed no significant variation of macular function between baseline evaluation and second evaluation at end of the follow-up. Our study demonstrates that, in our group of epileptic patients, epilepsy per se does not affect color vision and retinal function. In contrast, after 1 years of therapy with VPA and CBZ these patients showed a deficit in FM 100-hue test although nyctometry evaluation continued to be normal allowing to exclude an impairment in macular function. Further investigations are required to determine the pathophysiological alteration(s) that are at the basis of color perception defects.
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Affiliation(s)
- A Verrotti
- Department of Pediatrics, University of Chieti, Chieti, Italy.
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12
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Lobefalo L, Rapinese M, Altobelli E, Di Mascio R, Lattanzi D, Gallenga PE, Chiarelli F, Verrotti A. Retinal nerve fiber layer and macular thickness in adolescents with epilepsy treated with valproate and carbamazepine. Epilepsia 2006; 47:717-9. [PMID: 16650137 DOI: 10.1111/j.1528-1167.2006.00505.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate retinal nerve retinal nerve fiber layer (RNFL) and macular thickness by using optical coherence tomography (OCT) in epileptic adolescents before and during monotherapy with valproic acid (VPA) and carbamazepine (CBZ). METHODS We examined prospectively 45 epilepsy patients with partial and generalized epilepsy. The patients were evaluated before the beginning of therapy and after 1 year of VPA or CBZ monotherapy. Forty-five untreated healthy controls were evaluated at baseline and after 1 year. RESULTS At the beginning of the study, the two groups of patients showed RNFL and macular thickness measurements similar to control values. At the end of the follow-up, the data of the three groups were similar to baseline, showing no significant differences in the evaluated parameters. CONCLUSIONS The present study demonstrates that no modification of RNFL and macular thickness parameters is found after 1 year of treatment with VPA and CBZ monotherapy.
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Affiliation(s)
- Lucio Lobefalo
- Department of Experimental Surgery, Section of Ophthalmology, University of Chieti, Italy
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13
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Sorri I, Kälviäinen R, Mäntyjärvi M. Color vision and contrast sensitivity in epilepsy patients treated with initial tiagabine monotherapy. Epilepsy Res 2005; 67:101-7. [PMID: 16257182 DOI: 10.1016/j.eplepsyres.2005.09.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2005] [Revised: 08/26/2005] [Accepted: 09/07/2005] [Indexed: 10/25/2022]
Abstract
The purpose of the study was to determine whether the use of a GABAergic antiepileptic drug (AED), tiagabine, affects color vision and contrast sensitivity. Twenty newly diagnosed patients with partial epilepsy (aged 19-72 years), receiving tiagabine as their initial monotherapy for 5-41 months were examined. Color vision was examined with the Standard Pseudoisochromatic Plates 2 (SPP2), with the Farnsworth-Munsell 100 Hue Test (FM100) and with the Color Vision Meter 712 (CVM) anomaloscope. Contrast sensitivity was measured with the Pelli-Robson letter chart. Three patients excluded from the color vision evaluation for congenital red-green color vision defects. Seven out of 17 patients (41%) had acquired color vision deficit examined with the FM100. The CVM anomaloscope revealed minor defects in two patients. Contrast sensitivity function was within normal ranges. The present study suggests that AED therapy with tiagabine, like with other established and newer AEDs may interfere with color perception.
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Affiliation(s)
- Iiris Sorri
- Department of Ophthalmology, Kuopio University Hospital, P.O. Box 1777, FIN-70211 Kuopio, Finland; Department of Ophthalmology, University of Kuopio, Kuopio, Finland.
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14
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Page JW, Crognale MA. Differential aging of chromatic and achromatic visual pathways: behavior and electrophysiology. Vision Res 2005; 45:1481-9. [PMID: 15743617 DOI: 10.1016/j.visres.2004.09.041] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2003] [Revised: 05/12/2004] [Accepted: 09/28/2004] [Indexed: 11/16/2022]
Abstract
Aging of visual pathways was measured psychophysically and physiologically in subjects aged 20-89 years. Contrast thresholds for the chromatic pathways increased with age, but there were no significant changes for thresholds of the achromatic pathway at low spatial frequencies. For visual evoked potential (VEP) responses, again only the chromatic pathways were significantly affected by age. Age-related changes in chromatic responses were not apparent when stimuli were adjusted by age-related contrast thresholds. This suggests that the chromatic and achromatic visual pathways age differently and that the VEP accurately and objectively reflects behavioral changes with age.
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Affiliation(s)
- Jonathan W Page
- Department of Psychology, University of Nevada, Reno, NV 89557, USA.
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15
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Geller AM, Hudnell HK, Vaughn BV, Messenheimer JA, Boyes WK. Epilepsy and Medication Effects on the Pattern Visual Evoked Potential*. Doc Ophthalmol 2005; 110:121-31. [PMID: 16249963 DOI: 10.1007/s10633-005-7350-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Visual disruption in patients diagnosed with epilepsy may be attributable to either the disease itself or to the anti-epileptic drugs prescribed to control the seizures. Effects on visual function may be due to perturbations of the GABAergic neurotransmitter system, since deficits in GABAergic cortical interneurons have been hypothesized to underlie some forms of epilepsy, some anti-epileptic medications increase cortical GABA levels, and GABAergic neural circuitry plays an important role in mediating the responses of cells in the visual cortex and retina. This paper characterizes the effects of epilepsy and epilepsy medications on the visual evoked response to patterned stimuli. Steady-state visual evoked potentials (VEP) evoked by onset-offset modulation of high-contrast sine-wave stimuli were measured in 24 control and 54 epileptic patients. Comparisons of VEP spectral amplitude as a function of spatial frequency were made between controls, complex partial, and generalized epilepsy groups. The effects of the GABA-active medication valproate were compared to those of carbamezepine. The amplitude of the fundamental (F1) component of the VEP was found to be sensitive to epilepsy type. Test subjects with generalized epilepsy had F1 spatial frequency-amplitude functions with peaks shifted to lower spatial frequencies relative to controls and test subjects with complex partial epilepsy. This shift may be due to reduced intracortical inhibition in the subjects with generalized epilepsy. The second harmonic component (F2) response was sensitive to medication effects. Complex partial epilepsy patients on VPA therapies showed reduced F2 response amplitude across spatial frequencies, consistent with previous findings that showed the F2 response is sensitive to GABA-ergic effects on transient components of the VEP.
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Affiliation(s)
- Andrew M Geller
- Neurotoxicology Division, National Health and Environmental Effects Research Laboratory, US Environmental Protection Agency, Research Triangle Park, NC 27711, USA.
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16
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Verrotti A, Lobefalo L, Priolo T, Rapinese M, Trotta D, Morgese G, Gallenga PE, Chiarelli F. Color vision in epileptic adolescents treated with valproate and carbamazepine. Seizure 2004; 13:411-7. [PMID: 15276145 DOI: 10.1016/j.seizure.2003.09.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE The aims of our study were to evaluate whether deficits in color vision exist in epileptic adolescents, to study if monotherapy with valproic acid (VPA) and carbamazepine (CBZ) can affect color vision, and to determine the possible relationship between abnormal color vision tests and AEDs dosage and their serum concentrations. PATIENTS We examined 45 epileptic patients before the beginning of therapy and after 1 year of VPA or CBZ monotherapy and 40 sex- and age-matched healthy controls. METHODS Color vision was evaluated with Farnsworth Munsell 100 (FM100) hue test and achromatic and short-wavelength automated perimetry (SWAP). STATISTICAL ANALYSIS To evaluate intergroup differences we used ANOVA with Scheffe's post hoc test, when appropriate. Repeated measures ANOVA was used to evaluate the intragroup modifications of total error score (TES) and perimetric threshold during the follow-up. Pearson's correlation test was performed to correlate chromatic sense and perimetric data and AEDs dosage and serum concentrations. RESULTS Before the beginning of therapy, there were no differences in central color vision and SWAP between controls and epileptic patients. After 1 year, patients treated with VPA or CBZ showed a deficit in FM100 hue test and SWAP parameters while no significant deficit was found in achromatic perimetry. In particular, with the FM100 hue test a higher number of errors was found in both groups of patients (CBZ patients: 166.00 +/- 27.72 TES; VPA patients: 151.19 +/- 44.09, P < 0.001) in comparison with controls (controls: 109.29 +/- 24.73) and baseline values (CBZ patients: 110.65 +/- 22.9; VPA patients 107.43 +/- 21.70). With SWAP patients of both groups showed significant variation of foveal threshold (controls: 21.07 +/- 2.01 dB; CBZ patients: 19.35 +/- 1.32, P < 0.001; VPA patients: 18.88 +/- 1.89, P < 0.001), full-field mean threshold perimetric sensitivity (controls: 18.50 +/- 1.24 dB; CBZ patients: 16.60 +/- 1.47, P < 0.001; VPA patients: 16.23 +/- 1.55, P < 0.001) and mean threshold perimetric sensitivity of the three evaluated subareas of the visual field (area 1 controls: 21.01 +/- 1.15; CBZ patients: 19.45 +/- 1.74, P = 0.001; VPA patients: 18.25 +/- 1.61, P < 0.001; area 2 controls: 18.40 +/- 1.43; CBZ patients: 16.07 +/- 1.58, P +/- 0.001; VPA patients: 16.13 +/- 1.46, P = 0.001; area 3 controls: 17.20 +/- 1.49; CBZ patients: 14.28 +/- 1.51, P < 0.001; VPA patients: 14.31 +/- 2.90, P = 0.001). CONCLUSIONS Our study demonstrates that treatment with VPA or CBZ can affect significantly both central and paracentral color vision after a short treatment period.
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Affiliation(s)
- A Verrotti
- Division of Pediatric, Department of Medicine, Ospedale Policlinico, via dei Vestini 5, I-66100 Chieti, Italy.
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17
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Abstract
Visual disturbances are a common side-effect of many antiepileptic drugs. Non-specific retino- and neurotoxic visual abnormalities, that are often reported with over-dosage and prolonged AED use, include diplopia, blurred vision and nystagmus. Some anticonvulsants are associated with specific visual problems that may be related to the mechanistic properties of the drug, and occur even when the drugs are administered within the recommended daily dose. Vigabatrin, a GABA-transaminase inhibitor, has been associated with bilateral concentric visual field loss, electrophysiological changes, central visual function deficits including reduced contrast sensitivity and abnormal colour perception, and morphological alterations of the fundus and retina. Topiramate, a drug that enhances GABAergic transmission, has been associated with cases of acute closed angle glaucoma, while tiagabine, a GABA uptake inhibitor, has been investigated for a potential GABAergic effect on the visual field. Only mild neurotoxic effects have been identified for patients treated with gabapentin, a drug designed as a cyclic analogue of GABA but exhibiting an unknown mechanism while carbamazepine, an inhibitor of voltage-dependent sodium channels, has been linked with abnormal colour perception and reduced contrast sensitivity. The following review outlines the visual disturbances associated with some of the most commonly prescribed anticonvulsants. For each drug, the ocular site of potential damage and the likely mechanism responsible for the adverse visual effects is described.
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Affiliation(s)
- Emma J Roff Hilton
- Neurosciences Research Institute, School of Life and Health Sciences, Aston University, Aston Triangle, Birmingham B4 7E7, UK
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18
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Iregren A, Andersson M, Nylén P. Color vision and occupational chemical exposures: I. An overview of tests and effects. Neurotoxicology 2002; 23:719-33. [PMID: 12520762 DOI: 10.1016/s0161-813x(02)00088-8] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The paper presents a summary of the literature published until December 2000 on effects from some industrial chemical exposures on color perception, as well as short descriptions of the tests applied. Several different tests have been used to study acquired alterations of color vision. These changes are frequently found in the blue-yellow axis. Many of the tests were originally designed to detect congenital alterations in the red-green axis, and thus have relatively low sensitivity when studying chemically induced deficits in color perception. At present, the Lanthony D15-desaturated panel seems most suitable for application in industrial settings, since it is clearly the most sensitive and easily administered test. Color vision seems to be a physiological function very sensitive to several chemicals. The potency of industrial chemicals to induce color vision deficiencies has often been investigated during the last two decades. The chemicals most frequently studied are different solvents and mercury. Pronounced effects on color perception have been reported following chronic exposure to organic solvents such as styrene, carbon disulphide, perchloroethylene, n-hexane and solvent mixtures, and to organic as well as inorganic mercury. The effect of occupational toluene exposure seems not as well established, since only slight effects and several negative studies have been reported. For some of these compounds the effect on color vision has been further established through the finding of clear dose-effect relationships. In a few cases, even acute exposure situations, e.g. exposure to toluene for a few hours or acute alcohol intake, seem to affect color perception. Follow-up studies are needed to investigate the possible reversibility of effects in relation to discontinued or reduced exposures.
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Affiliation(s)
- Anders Iregren
- National Institute for Working Life, SE-112 79 Stockholm, Sweden.
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Kinnear PR, Sahraie A. New Farnsworth-Munsell 100 hue test norms of normal observers for each year of age 5-22 and for age decades 30-70. Br J Ophthalmol 2002; 86:1408-11. [PMID: 12446376 PMCID: PMC1771429 DOI: 10.1136/bjo.86.12.1408] [Citation(s) in RCA: 121] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIMS To provide normative data for chromatic discrimination on the Farnsworth-Munsell 100 hue test particularly for observers under 23 years of age. METHODS Normal observers were screened for congenital colour vision deficiencies using the Ishihara test leaving 382 observers. RESULTS New total error score (TES) norms (means and 95th percentiles) are presented for each year of age from 5-22 and for 10 year age groups from the 30s to the 70s. These norms are presented as actual values (TES) and also as square root values ( radical TES). Other data include partial error scores for red-green and blue-yellow axes discrimination. CONCLUSION This study provides the most detailed set of normative data to date. The data are also in agreement with other reports of chromatic discrimination, showing that the performance in this task varies as a U-shape function with age, the best being achieved at 19 years of age.
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Affiliation(s)
- P R Kinnear
- Vision Research Laboratories, Department of Psychology, University of Aberdeen, UK.
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20
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Wang C, Tan X, Bi Y, Su Y, Yan J, Ma S, He J, Braeckman L, De Bacquer D, Wang F, Vanhoorne M. Cross-sectional study of the ophthalmological effects of carbon disulfide in Chinese viscose workers. Int J Hyg Environ Health 2002; 205:367-72. [PMID: 12173535 DOI: 10.1078/1438-4639-00168] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This article presents cross-sectional investigation results of ophthalmological effects for the occupational exposure to carbon disulfide of workers at a large viscose fibre factory in the middle part of China. The total of 271 exposed subjects (191 males, 80 females) and 133 workers (93 males, 40 females) not exposed to any toxic agent in the working environment underwent ophthalmological examination. The self-administered questionnaire collected data on the medical history and ophthalmological complaints during the past three months. The ophthalmologic examination included routine examination for retinal capillary anomalies and and color vision with the FM 100-Hue test method. Nearly all subjects did not use respirators, smocks or aprons, gloves or other personal protective devices during work time. The average personal CS2 exposure level in the present study was 13.7-20.05 mg/m3. The FM 100-Hue test results showed that the total error scores of the exposed group, whether male or female, were higher than that of the control, the discrimination of the green and blue zones was also impaired significantly. A fundus examination showed no retinal capillary anomalies or other serious ophthalmological symptoms that may be related to effects of CS2. In conclusion, color vision was disturbed in workers exposed to CS2, at levels below the present threshold value. Reduced color discrimination may be attributed to long-term carbon disulfide exposure and suggests that health surveillance of workers exposed to carbon disulfide should include the FM 100-Hue Test as a sensitive and easy method.
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Affiliation(s)
- Chunhong Wang
- Dept. of Occupational and Environment Health, School of Public Health, Wuhan University, Wuhan 430071, P.R. of China
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21
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Shores MM, Sloan KL. Phenytoin-induced visual disturbances misdiagnosed as alcohol withdrawal. PSYCHOSOMATICS 2002; 43:335-6. [PMID: 12189261 DOI: 10.1176/appi.psy.43.4.335] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
PURPOSE To examine changes in the chromatic onset visual evoked potential (VEP) as a function of aging. METHODS VEP's were measured in response to chromatic sinusoidal gratings (1.0 and 0.5 cpd), selectively chosen to modulate the L-M channel and S - (L+M) channel and presented in onset-offset mode. Responses to achromatic gratings presented in a reversal mode were also measured. Twenty subjects were tested, ranging in age from 21 to 93 years. RESULTS Unlike changes observed earlier in life, the general shape of the chromatic onset wave-form changed little with age; however, latencies increased significantly as a function of age. Amplitude changes revealed a decreasing trend that was not statistically significant. There was little change in the achromatic responses with age. CONCLUSIONS Our results demonstrate a systematic slowing of the chromatic onset VEP with age. The gradual nature of the latency changes and the lack of dramatic and complex wave-form shape changes may allow development of age-based normative data for use in clinical settings.
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Affiliation(s)
- M A Crognale
- Department of Psychology, University of Nevada, Reno 89557, USA.
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23
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Abstract
PURPOSE To evaluate the effect of laser in situ keratomileusis (LASIK) on color vision. SETTING Department of Ophthalmology, China Medical College Hospital, Taichung, Taiwan. METHOD This prospective study comprised consecutive patients having LASIK. Patients were eligible for inclusion if they had a best corrected visual acuity of 20/20 or better and a normal color vision test preoperatively and an uncorrected near visual acuity of 20/40 or better postoperatively. Color vision was tested using the Farnsworth-Munsell 100-hue test (FM 100 test) preoperatively and 1 day, 1 week, and 1 month postoperatively. RESULTS Twenty-nine eyes of 15 patients having LASIK were enrolled in the study. The mean patient age was 29.2 years +/- 2.9 (SD). The mean preoperative spherical equivalent refractive error was -5.6 +/- 1.8 diopters, and the mean preoperative error score of the FM 100 test was 3.79 +/- 1.55. After surgery, no significant change in the error score was observed at 1 day (4.30 +/- 1.07, P =.1039, paired t test), 1 week (3.72 +/- 1.25, P =.8125, paired t test), or 1 month (3.97 +/- 1.29, P =.6149, paired t test). CONCLUSION Laser in situ keratomileusis did not affect color vision evaluated by the FM 100 test.
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Affiliation(s)
- Y Y Tsai
- Department of Ophthalmology, China Medical College Hospital, Taichung, Taiwan
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Nousiainen I, Kälviäinen R, Mäntyjärvi M. Color vision in epilepsy patients treated with vigabatrin or carbamazepine monotherapy. Ophthalmology 2000; 107:884-8. [PMID: 10811079 DOI: 10.1016/s0161-6420(00)00077-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To investigate color vision in epilepsy patients treated with vigabatrin or carbamazepine monotherapy and to evaluate the association between vigabatrin-induced visual field defects and dyschromatopsia. DESIGN Nonrandomized comparative trial. PARTICIPANTS Thirty-two epilepsy patients treated with vigabatrin monotherapy, 18 patients treated with carbamazepine monotherapy, and 47 age-matched healthy controls were examined. MAIN OUTCOME MEASURES Color vision was examined with Standard Pseudoisochromatic Plates 2 (SPP2) screening test, Farnsworth-Munsell 100 (FM 100) hue test, and Color Vision Meter 712 anomaloscope. RESULTS Abnormal color perception was found in 32% of the epilepsy patients treated with vigabatrin monotherapy and 28% of the epilepsy patients treated with carbamazepine monotherapy. The total error score in the Farnsworth-Munsell 100 hue test was abnormally high in the vigabatrin monotherapy patients who had concentrically constricted visual fields and a statistically significant correlation was found between the temporal visual field extents and the age-adjusted Farnsworth-Munsell 100 total error score in vigabatrin monotherapy patients (R = .533, P = 0.003 in the right eye, R = .563, P = 0.001 in the left eye). Four of 31 (12%) vigabatrin monotherapy patients, and 1 of 18 (6%) carbamazepine monotherapy patients had a blue axis in Farnsworth-Munsell 100 hue test. In the anomaloscope, there were a few pathologic findings in both groups. In the SPP2 screening test, a few plates were not seen in both groups. CONCLUSIONS Both examined antiepileptic drugs, vigabatrin and carbamazepine, cause acquired color vision defects. The abnormal color perception seems to be associated with constricted visual fields in the vigabatrin monotherapy patients. The duration of carbamazepine therapy correlates with high FM100 total error score. The best method for detecting dyschromatopsia in patients treated with vigabatrin or carbamazepine was the Farnsworth-Munsell 100 hue test. The SPP2 screening test does not seem to be useful in clinical practice.
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Affiliation(s)
- I Nousiainen
- Department of Ophthalmology, Kuopio University Hospital, Finland
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O'Sullivan EP, Kennard C. Ocular manifestations of neurological disease. Curr Opin Neurol 1998; 11:25-9. [PMID: 9484613 DOI: 10.1097/00019052-199802000-00005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This review covers the recent developments in the diagnosis, natural history and treatment of several common neuro-opthalmological disorders, such as optic neuritis, pseudotumour cerebri and nonarteritic anterior ischaemic optic neuropathy. It also deals briefly with the effects on the eye of the ataxias and antiepileptic drugs.
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Affiliation(s)
- E P O'Sullivan
- Western Eye Hospital, Imperial College of Science, Technology and Medicine, London, UK
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